ORGAN TRANSPLANT: House and Senate Negotiations Fail

      House and Senate members have failed to resolve the "bitter fight" over whether HHS or the United Network for Organ Sharing should have the "final say" regarding transplant policy, the AP/San Francisco Examiner reports. The breakdown in negotiations makes it "virtually certain" that Congress will not approve new rules for organ distribution before it adjourns. At issue is whether organs should be distributed based on the geographic region of the organ donor and recipient, as in the past, or based on recipients' medical needs, independent of geography. In 1998, the Clinton administration issued new rules directing UNOS to distribute organs to the sickest patients first regardless of geography, but the regulations met opposition from UNOS and Congress. Last month, UNOS signed a new contract with HHS that cedes authority to the agency to decide all policy issues and compose regulations. However, Congress had also "hoped to set guiding principles into law." Earlier this year, the House passed a bill that "strips HHS of its power to set policy" and gives UNOS "complete control" over organ distribution. The Senate then "crafted a compromise" under the direction of Sens. Bill Frist (R-Tenn.) and Edward Kennedy (D-Mass.), which "would balance power" between HHS and UNOS and calls for a "panel of medical experts" to have final say on policy matters. In discussions over the past two weeks, House and Senate negotiators have been unable to bridge their differences. An aide to Kennedy said there was little motive for supporters of the Clinton administration to compromise since HHS' contract with UNOS has been signed, as the new regulations will remain in effect unless Congress takes additional action. On the House side, Pete Sheffield, an aide to House Commerce Committee Chair Tom Bliley (R-Va.), "one of the administration's fiercest opponents" on organ transplant policy, said he was disappointed with the Senate's "take it or leave it" attitude (Meckler, AP/San Francisco Examiner, 10/17).